This application is a request for a Mentored Patient-Oriented Research Career Development Award to support the training and research activities necessary for Karin Hoth, Ph.D. to further develop into an independent investigator examining cardiopulmonary mechanisms that impact cognitive function. The applicant is a clinical neuropsychologist with research training and experience in aging and cardiovascular disease. The application extends Dr. Hoth's previous experience by integrating aspects of cardiovascular and pulmonary physiology as risk factors influencing cognitive decline in COPD. Training will be obtained through intensive didactic and hands-on research experiences available at National Jewish Health and the University of Colorado Denver. The training environment includes an interdisciplinary COPD clinical and research program with experts in pulmonary medicine, cardiology, and behavioral medicine. COPD is the fourth leading cause of combined morbidity, disability, and mortality in the United States, and is the only leading cause that is increasing in the elderly. Cognitive impairment is common in COPD, but the full range of underlying mechanisms that impact cognitive function in this population are not well understood. In the present study, we propose to examine the relationships among hypoxemia, diminished peripheral vascular reactivity, and cognitive impairment in patients with COPD. The career development plan is focused on three primary goals: 1) gaining knowledge related to cardiopulmonary physiology and the effects of physiological changes in COPD on the central nervous system; 2) improving knowledge of techniques for assessing cardiopulmonary physiology; and 3) developing skills related to conducting interdisciplinary research in the medical setting. The proposed project and training activities will lay the foundation for Dr. Hoth's long-term goal to develop an independent program of research to understand how alterations in the cardiopulmonary system as a whole impact the brain and cognitive functioning.